Gardner, Timothy Andrew

Gardner, Timothy Andrew is an individual health care provider with primary practice located at 2444 W Faidley Ave , Grand Island NE 68803-4327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gardner, Timothy Andrew can be contacted via phone (308) 382-1100.

Contact Information

Primary practice address
2444 W Faidley Ave Grand Island NE 68803-4327
Phone: (308) 382-1100
Fax: (308) 385-0796
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20515 Nebraska

Profile Details

NPI number 1376543322
LBN Legal business name Gardner, Timothy Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Nov 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376543322 NPPES
Nebraska MEDICAID 47017633037
Nebraska Other 34032
Nebraska Other 240082

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